America's future and health care reform.
Explore the source record for details and available documents.
Forecasting↗
Biomedical subjects
M E Richard
Publications and source records attributed to M E Richard.
Common pediatric craniofacial reconstructions.
The emphasis on beauty in our society also places demands on children to meet a certain appearance. With cleft lip and palate being one of the most common birth defects, it is likely that pediatric nurses or pediatric nurse practitioners will encounter children requiring a form of craniofacial surgery. This article discusses common reconstruction techniques and important features of care.
Child↗
Expanded full-thickness skin grafts in children: case selection, planning, and management.
Since our initial presentation of our experience with tissue expansion as a means of harvesting large full-thickness skin grafts in children in 1987, we have continued to "expand" both the size of full-thickness skin grafts harvested and the range of reconstructive problems to which we have applied the technique. Sixteen expanded full-thickness grafts have been used for immediate reconstruction following giant nevus excision and in postburn reconstruction. Patients ranged in age from 6 months to 15 years, with follow-up ranging from 6 months to 6 1/2 years. Grafts ranging in size from approximately 60 cm2 (excluding the dimensions of one submental graft) to greater than 700 cm2 were harvested from expanded donor sites on unilateral or bilateral groin/lower abdomen, clavicular, and a single submental expansion. Five expanded full-thickness grafts were used in facial reconstruction for single aesthetic unit coverage, multiple unit, and one single-sheet full facial graft. One expanded full-thickness graft was used on the breast. Three grafts were used in dorsal hand and finger coverage, and seven were used on the lower extremity, including an entire plantar surface and toes. Graft loss was confined to a 6.25-cm2 area on one cheek in the full facial expanded full-thickness grafts and a 9-cm2 area on the non-weight-bearing area of the full plantar graft. Donor-site complications were negligible. The anatomic confines of the donor sites and size of the patient may require expander replacement (in situ serial expansion) in order to obtain a large enough graft and accomplish primary donor-site closure. Expander and injection port placement in children for ease of injection and planned expander change must be anticipated. Our protocol from preoperative teaching through graft take is reviewed. Experience has demonstrated that expanded full-thickness grafts maintain all the characteristics of non-expanded full-thickness skin grafts and are an excellent reconstructive option in children.
Adolescent↗
Feeding the newborn with cleft lip and/or palate: the enlargement, stimulate, swallow, rest (ESSR) method.
The failure of newborns with cleft lip and/or cleft palate to properly gain weight remains a frustrating reality for many families regardless of the complex medical technology designed to avoid this problem. The enlargement, stimulate, swallow, suck (ESSR) feeding method was developed to easily and inexpensively reduce the occurrence of poor weight gain among these patients. Families and health care providers will benefit from adopting this method which encourages and provides successful feeding experiences for everyone involved with this group of patients that were once thought of as difficult to feed.
Cleft Lip↗
Preparation of the child for tissue expansion: a developmental approach.
Explore the source record for details and available documents.
Adolescent↗
The role of tissue expansion in pediatric plastic surgery.
The ability to increase available local tissue by controlled soft tissue expansion (TE) has led to a rapid increase in the use of TE in clinical practice. This article reviews some general guidelines when using TE in children and addresses some of the concerns previously expressed regarding the effects of TE on growth in infants and children.
Adolescent↗
[Urine collector with disposable reservoir for women].
Explore the source record for details and available documents.
Disposable Equipment↗
Weight comparisons of infants with complete cleft lip and palate.
PURPOSE: To evaluate the success of the Enlarge, Stimulate, Swallow, Rest (ESSR) feeding method for infants with complete cleft lip and palate. METHOD: Sixty-nine infants comprised of two groups: an ESSR group and a control group. Paired t-tests compared mean weights at birth and time of surgery according to feeding method. RESULTS: Infants fed by ESSR method showed greater mean weight gain. CONCLUSIONS: The ESSR method appeared to be successful in promoting weight gain.
Body Weight↗